Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis
Abstract Background Euthyroid sick syndrome (ESS) frequently arises in children admitted with diabetic ketoacidosis/diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children suffering from DKA/DK. Methods...
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| Language: | English |
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BMC
2020-09-01
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| Series: | BMC Endocrine Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12902-020-00616-2 |
| _version_ | 1819038691512811520 |
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| author | Peng Shao Shujuan Guo Guimei Li Daogang Qin Sen Li Ying Luan |
| author_facet | Peng Shao Shujuan Guo Guimei Li Daogang Qin Sen Li Ying Luan |
| author_sort | Peng Shao |
| collection | DOAJ |
| description | Abstract Background Euthyroid sick syndrome (ESS) frequently arises in children admitted with diabetic ketoacidosis/diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children suffering from DKA/DK. Methods 98 DKA and 96 DK pediatric patients were selected from hospital records. Those on thyroxine replacement, with overt hypothyroidism, or with positive anti-thyroperoxidase (TPO) antibody were excluded. Tests for liver function, renal function, lipid profile, serum osmolarity, thyroid function, c-peptide levels, and glycosylated hemoglobin were done on all patients. Children were divided into euthyroid (n = 88) and ESS groups (n = 106). Results The ESS group had a higher level of white blood cell count (WBC), plasma glucose (PG), beta-hydroxybutyric acid (β-HB), triglyceride (TG), anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO3 −, prealbumin (PA), and albumin (ALB) compared with the euthyroid group (P < 0.05). Free T3 (FT3) levels were significantly correlated to β-HB, HCO3 −, AG, PA, and HbA1c (r = − 0.642, 0.681, − 0.377, 0.581, − 0.309, respectively; P < 0.01). Free T4 (FT4) levels were significantly correlated to β-HB, HCO3 −, and ALB levels (r = − 0.489, 0.338, 0.529, respectively; P < 0.01). TSH levels were significantly affected by HCO3 − only (r = − 0.28; P < 0.01). HCO3 − level was the most important factor deciding euthyroid or ESS on logistic regression analysis (OR = 0.844, P = 0.004, 95%CI = 0.751–0.948). Conclusions Lower levels of free thyroid hormones and occurrence of ESS were associated with a higher degree of acidosis in children with DKA/DK. |
| first_indexed | 2024-12-21T08:41:20Z |
| format | Article |
| id | doaj.art-db818a9288cb4217a9e6640279a7155b |
| institution | Directory Open Access Journal |
| issn | 1472-6823 |
| language | English |
| last_indexed | 2024-12-21T08:41:20Z |
| publishDate | 2020-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Endocrine Disorders |
| spelling | doaj.art-db818a9288cb4217a9e6640279a7155b2022-12-21T19:09:57ZengBMCBMC Endocrine Disorders1472-68232020-09-012011810.1186/s12902-020-00616-2Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosisPeng Shao0Shujuan Guo1Guimei Li2Daogang Qin3Sen Li4Ying Luan5Department of Pediatrics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Pediatrics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Pediatrics, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Pediatrics, Liaocheng People’s HospitalDepartment of Endocrinology, Liaocheng People’s HospitalDepartment of Pediatrics, Liaocheng People’s HospitalAbstract Background Euthyroid sick syndrome (ESS) frequently arises in children admitted with diabetic ketoacidosis/diabetic ketosis (DKA/DK). This study evaluates the interplay of various metabolic factors with occurrence of deranged thyroid function tests in children suffering from DKA/DK. Methods 98 DKA and 96 DK pediatric patients were selected from hospital records. Those on thyroxine replacement, with overt hypothyroidism, or with positive anti-thyroperoxidase (TPO) antibody were excluded. Tests for liver function, renal function, lipid profile, serum osmolarity, thyroid function, c-peptide levels, and glycosylated hemoglobin were done on all patients. Children were divided into euthyroid (n = 88) and ESS groups (n = 106). Results The ESS group had a higher level of white blood cell count (WBC), plasma glucose (PG), beta-hydroxybutyric acid (β-HB), triglyceride (TG), anion gap (AG), glycosylated hemoglobin (HbA1c) and a lower level of HCO3 −, prealbumin (PA), and albumin (ALB) compared with the euthyroid group (P < 0.05). Free T3 (FT3) levels were significantly correlated to β-HB, HCO3 −, AG, PA, and HbA1c (r = − 0.642, 0.681, − 0.377, 0.581, − 0.309, respectively; P < 0.01). Free T4 (FT4) levels were significantly correlated to β-HB, HCO3 −, and ALB levels (r = − 0.489, 0.338, 0.529, respectively; P < 0.01). TSH levels were significantly affected by HCO3 − only (r = − 0.28; P < 0.01). HCO3 − level was the most important factor deciding euthyroid or ESS on logistic regression analysis (OR = 0.844, P = 0.004, 95%CI = 0.751–0.948). Conclusions Lower levels of free thyroid hormones and occurrence of ESS were associated with a higher degree of acidosis in children with DKA/DK.http://link.springer.com/article/10.1186/s12902-020-00616-2DiabetesThyroid functionMetabolic changesType 1 diabetesChildren |
| spellingShingle | Peng Shao Shujuan Guo Guimei Li Daogang Qin Sen Li Ying Luan Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis BMC Endocrine Disorders Diabetes Thyroid function Metabolic changes Type 1 diabetes Children |
| title | Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis |
| title_full | Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis |
| title_fullStr | Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis |
| title_full_unstemmed | Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis |
| title_short | Determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis/diabetic ketosis |
| title_sort | determinants of deranged thyroid function parameters in children admitted for management of diabetic ketoacidosis diabetic ketosis |
| topic | Diabetes Thyroid function Metabolic changes Type 1 diabetes Children |
| url | http://link.springer.com/article/10.1186/s12902-020-00616-2 |
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